Chan K H, Cheung R T F, Liu W M, Mak W, Ho S L
Division of Neurology, University Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong.
J Clin Neurosci. 2005 Feb;12(2):186-8. doi: 10.1016/j.jocn.2004.03.013.
Cerebral venous thrombosis (CVT) is an uncommon but serious type of stroke. Thrombosis may involve the cortical or deep veins or the venous sinuses. The presenting clinical features are non-specific. We report a 48-year-old man with CVT who presented with fever, bitemporal throbbing headache, and generalised convulsion. Computed tomography (CT) of the brain revealed acute haemorrhages over right anterior frontal and posterior temporal regions with surrounding oedema and right anterior temporal subcortical oedema. The initial diagnosis was herpes simplex encephalitis. Absence of venous flow over the right transverse and sigmoid sinuses during the venous phase of digital subtraction angiography (DSA) revealed CVT. He was anti-coagulated for 6 months. An underlying cause of CVT was not detected. A high index of suspicion is required when risk factors of CVT are present. CT brain may be normal or showing non-specific findings. Magnetic resonance imaging plus venography, CT venography, or DSA is diagnostic.
脑静脉血栓形成（CVT）是一种罕见但严重的中风类型。血栓形成可能累及皮质静脉或深静脉或静脉窦。其临床表现不具有特异性。我们报告一例48岁患有CVT的男性患者，其表现为发热、双侧颞部搏动性头痛和全身性惊厥。脑部计算机断层扫描（CT）显示右额前部和颞后部急性出血伴周围水肿以及右颞前皮下水肿。最初诊断为单纯疱疹性脑炎。数字减影血管造影（DSA）静脉期右横窦和乙状窦未见血流，提示CVT。他接受了6个月的抗凝治疗。未检测到CVT的潜在病因。当存在CVT危险因素时，需要高度怀疑。脑部CT可能正常或显示非特异性表现。磁共振成像加静脉造影、CT静脉造影或DSA具有诊断价值。
